单独及联合检测血清高尔基糖蛋白-3和甲胎蛋白对肝癌的诊断价值。
Diagnostic value of serum glypican-3 alone and in combination with AFP as an aid in the diagnosis of liver cancer.
机构信息
Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.17, Panjiayuannanli, Chaoyang District, Beijing 100021, China; Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No.17, Panjiayuannanli, Chaoyang District, Beijing 100021, China.
Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.17, Panjiayuannanli, Chaoyang District, Beijing 100021, China.
出版信息
Clin Biochem. 2020 May;79:54-60. doi: 10.1016/j.clinbiochem.2020.02.009. Epub 2020 Feb 19.
BACKGROUND
Recently, a series of studies have been published to examine the possible diagnostic and prognostic values of glypican-3 (GPC3) in liver cancer with conflicting results observed. Thus, the present study aimed to assess the values of preoperative serum GPC3 alone and in combination with AFP for the diagnosis of liver cancer.
METHODS
An enzyme-linked immunoassay was used to quantify serum GPC3 in hepatocellular carcinoma group (HCC, n = 210), intrahepatic cholangiocarcinoma group (ICC, n = 36), combined hepatocellular cholangiocarcinoma group (cHCC-CC, n = 8), metastatic liver cancer group (MLC, n = 10) and normal controls (NC, n = 134).
RESULTS
The area under the curve (AUC) of GPC3 for HCC versus NC was 0.879, with a sensitivity of 79.52% at an optimal cutoff value of 0.0414 ng/mL; when GPC3 was combined with AFP, the AUC and sensitivity were increased to 0.925 and 88.10%, respectively. In addition, 43 of 68 AFP-negative patients had elevated GPC3 levels. Furthermore, the positive rate of GPC3 was significantly higher than the that of AFP for HCC in early stage.
CONCLUSIONS
Serum GPC3 was superior to AFP for the diagnosis of early-stage HCC, and may be complementary to AFP for distinguishing HCC from NC.
背景
最近，一系列研究发表，旨在探讨磷脂酰聚糖-3（GPC3）在肝癌中的诊断和预后价值，但结果存在争议。因此，本研究旨在评估术前血清 GPC3 单独和联合 AFP 对肝癌的诊断价值。
方法
采用酶联免疫吸附法检测肝癌组（HCC，n=210）、肝内胆管癌组（ICC，n=36）、混合型肝癌胆管癌组（cHCC-CC，n=8）、转移性肝癌组（MLC，n=10）和正常对照组（NC，n=134）血清 GPC3。
结果
GPC3 对 HCC 与 NC 的曲线下面积（AUC）为 0.879，最佳截断值为 0.0414ng/ml 时，灵敏度为 79.52%；当 GPC3 与 AFP 联合检测时，AUC 和灵敏度分别提高至 0.925 和 88.10%。此外，68 例 AFP 阴性患者中有 43 例 GPC3 水平升高。此外，GPC3 的阳性率明显高于 AFP 对早期 HCC 的阳性率。
结论
血清 GPC3 对早期 HCC 的诊断优于 AFP，且对 AFP 阴性的 HCC 与 NC 具有鉴别价值。
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